401k Plan data: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN plan

SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 401k Plan overview

Plan Name	SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN
Plan identification number	001

SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

DANI INSTRUMENTS, INC. has sponsored the creation of one or more 401k plans.

Company Name: DANI INSTRUMENTS, INC.

Employer identification number (EIN): 611614286

NAIC Classification: 325900
NAIC Description: Other Chemical Product and Preparation Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2018-01-01
001 2017-01-01 GEORGE GIANSANTI
001 2016-01-01 GEORGE GIANSANTI
001 2015-01-01 GEORGE GIANSANTI
001 2014-01-01 GEORGE GIANSANTI
001 2013-01-01 GEORGE GIANSANTI
001 2012-01-01 GEORGE GIANSANTI

Plan Statistics for SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN

401k plan membership statisitcs for SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN

Measure Date Value
2018: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 9
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 1
Total of all active and inactive participants 2018-01-01 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 10
Number of participants with account balances 2018-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 10
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 1
Total of all active and inactive participants 2017-01-01 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 11
Number of participants with account balances 2017-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 8
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 2
Total of all active and inactive participants 2016-01-01 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 10
Number of participants with account balances 2016-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 11
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 1
Total of all active and inactive participants 2015-01-01 12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 12
Number of participants with account balances 2015-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 6
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 1
Total of all active and inactive participants 2014-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 7
Number of participants with account balances 2014-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 6
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 1
Total of all active and inactive participants 2013-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 7
Number of participants with account balances 2013-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 12
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 12
Number of participants with account balances 2012-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2018: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	9
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	1
Total of all active and inactive participants	2018-01-01	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	10
Number of participants with account balances	2018-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	10
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	1
Total of all active and inactive participants	2017-01-01	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	11
Number of participants with account balances	2017-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	8
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	2
Total of all active and inactive participants	2016-01-01	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	10
Number of participants with account balances	2016-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	11
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	1
Total of all active and inactive participants	2015-01-01	12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	12
Number of participants with account balances	2015-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	6
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	1
Total of all active and inactive participants	2014-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	7
Number of participants with account balances	2014-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	6
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	1
Total of all active and inactive participants	2013-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	7
Number of participants with account balances	2013-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	12
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	12
Number of participants with account balances	2012-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Financial Data on SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN

Measure	Date	Value
2018 : SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$48,744
Expenses. Total of all expenses incurred	2018-12-31	$0
Total plan assets at end of year	2018-12-31	$404,349
Total plan assets at beginning of year	2018-12-31	$355,605
Value of fidelity bond covering the plan	2018-12-31	$250,000
Total contributions received or receivable from participants	2018-12-31	$76,012
Other income received	2018-12-31	$-27,268
Net income (gross income less expenses)	2018-12-31	$48,744
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$404,349
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$355,605
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2018-12-31	$63,326
2017 : SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$109,027
Expenses. Total of all expenses incurred	2017-12-31	$139,716
Benefits paid (including direct rollovers)	2017-12-31	$139,716
Total plan assets at end of year	2017-12-31	$355,605
Total plan assets at beginning of year	2017-12-31	$386,294
Value of fidelity bond covering the plan	2017-12-31	$36,000
Total contributions received or receivable from participants	2017-12-31	$63,777
Other income received	2017-12-31	$45,250
Net income (gross income less expenses)	2017-12-31	$-30,689
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$355,605
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$386,294
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2017-12-31	$34,780
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$99,839
Expenses. Total of all expenses incurred	2016-12-31	$4,918
Total plan assets at end of year	2016-12-31	$386,294
Total plan assets at beginning of year	2016-12-31	$291,373
Value of fidelity bond covering the plan	2016-12-31	$38,650
Total contributions received or receivable from participants	2016-12-31	$78,902
Other income received	2016-12-31	$20,937
Net income (gross income less expenses)	2016-12-31	$94,921
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$386,294
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$291,373
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2016-12-31	$12,881
Value of corrective distributions	2016-12-31	$4,918
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$66,564
Expenses. Total of all expenses incurred	2015-12-31	$0
Total plan assets at end of year	2015-12-31	$291,373
Total plan assets at beginning of year	2015-12-31	$224,809
Value of fidelity bond covering the plan	2015-12-31	$30,000
Total contributions received or receivable from participants	2015-12-31	$70,052
Other income received	2015-12-31	$-3,488
Net income (gross income less expenses)	2015-12-31	$66,564
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$291,373
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$224,809
2014 : SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$69,792
Expenses. Total of all expenses incurred	2014-12-31	$2,943
Benefits paid (including direct rollovers)	2014-12-31	$2,943
Total plan assets at end of year	2014-12-31	$224,809
Total plan assets at beginning of year	2014-12-31	$157,960
Value of fidelity bond covering the plan	2014-12-31	$20,000
Total contributions received or receivable from participants	2014-12-31	$56,431
Other income received	2014-12-31	$13,361
Net income (gross income less expenses)	2014-12-31	$66,849
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$224,809
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$157,960
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$128,333
Expenses. Total of all expenses incurred	2013-12-31	$52,214
Benefits paid (including direct rollovers)	2013-12-31	$52,214
Total plan assets at end of year	2013-12-31	$157,960
Total plan assets at beginning of year	2013-12-31	$81,841
Value of fidelity bond covering the plan	2013-12-31	$20,000
Total contributions received or receivable from participants	2013-12-31	$87,785
Contributions received from other sources (not participants or employers)	2013-12-31	$12,754
Other income received	2013-12-31	$27,794
Net income (gross income less expenses)	2013-12-31	$76,119
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$157,960
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$81,841
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$81,841
Expenses. Total of all expenses incurred	2012-12-31	$0
Total plan assets at end of year	2012-12-31	$81,841
Total plan assets at beginning of year	2012-12-31	$0
Total contributions received or receivable from participants	2012-12-31	$80,798
Other income received	2012-12-31	$1,043
Net income (gross income less expenses)	2012-12-31	$81,841
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$81,841
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$0

Form 5500 Responses for SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN

2018: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: SPECTRA ANALYSIS INSTRUMENTS, INC. 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	First time form 5500 has been submitted	Yes
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

945894-01

Policy instance

Insurance contract or identification number	945894-01
Number of Individuals Covered	7
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $3,778
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,889
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

945894-01

Policy instance

Insurance contract or identification number	945894-01
Number of Individuals Covered	7
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,648
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,636
Insurance broker organization code?	3
Insurance broker name	BRADFORD NICHOLS/RAYMOND JAMES

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Company Name:	DANI INSTRUMENTS, INC.
Employer identification number (EIN):	611614286
NAIC Classification:	325900
NAIC Description:	Other Chemical Product and Preparation Manufacturing

Plan id#	Filing Submission Date	Name of Administrator
001	2018-01-01
001	2017-01-01	GEORGE GIANSANTI
001	2016-01-01	GEORGE GIANSANTI
001	2015-01-01	GEORGE GIANSANTI
001	2014-01-01	GEORGE GIANSANTI
001	2013-01-01	GEORGE GIANSANTI
001	2012-01-01	GEORGE GIANSANTI